1230PD - Updated results of a global phase II study with crizotinib in advanced ALK-positive non-small cell lung cancer (NSCLC)

Date 30 September 2012
Event ESMO Congress 2012
Session NSCLC, metastatic
Topics Anti-Cancer Agents & Biologic Therapy
Non-Small-Cell Lung Cancer, Metastatic
Presenter Dong-Wan Kim
Authors D. Kim1, M. Ahn2, P. Yang3, X. Liu4, T. De Pas5, L. Crinò6, S. Lanzalone7, A. Polli7, A. Shaw8
  • 1Department Of Internal Medicine, Seoul National University Hospital, 110-744 - Seoul/KR
  • 2Division Of Hematology/oncology, Department Of Medicine, Sungkyunkwan University School of Medicine Samsung Medical Center, 135-710 - Seoul/KR
  • 3Department Of Internal Medicine, National Taiwan University College of Medicine, Taipei/TW
  • 4Cancer Center, 307 Hospital of the Academy of Military Medical Sciences, 100071 - Beijing/CN
  • 5Medical Oncology Unit Of Respiratory Tract And Sarcomas, European Institute of Oncology, 20141 - Milano/IT
  • 6Department Of Medical Oncology, Ospedale Santa Maria della Misericordia, 06156 - Perugia/IT
  • 7Oncology, Pfizer, 20152 - Milano/IT
  • 8Hematology/oncology, Department Of Medicine, Massachusetts General Hospital, Boston/US

Abstract

Background

Anaplastic lymphoma kinase (ALK) is a known oncogenic driver in NSCLC, and approximately 5% of patients harbor ALK gene rearrangements. Crizotinib is a first-in-class, selective small-molecule ALK inhibitor with demonstrated clinical activity in ALK-positive NSCLC. PROFILE 1005 is a global, multicenter, open-label, single-arm phase II study evaluating the safety and efficacy of crizotinib in previously treated patients with ALK-positive advanced NSCLC.

Methods

Crizotinib 250 mg was administered BID to patients with ALK-positive advanced NSCLC who had received ≥1 chemotherapy for locally advanced/metastatic disease, including those with treated brain metastases. Most patients had centrally confirmed ALK-positivity by break-apart fluorescence in-situ hybridization, defined as ≥15% of tumor cells with split signals. Disease response was evaluated by RECIST 1.1 every 6 weeks.

Results

As of January 2012, 901 patients had been dosed. The first 261 patients who had enrolled and started crizotinib by February 2011, with a median duration of treatment of 48 weeks, were considered to be the mature population. Demographic, exposure, and efficacy results in both the overall and mature populations are provided in the table. Among all 901 patients, 15% discontinued treatment due to adverse events (AEs) and 10% had a dose reduction due to an AE. The most frequent AEs of any cause were vision disorder (54%), nausea (51%), diarrhea (44%), vomiting (44%), and constipation (37%), which were mostly grade 1/2.

Conclusions

Crizotinib demonstrated a high response rate that was durable, with a median progression-free survival of 8.1 months. Crizotinib has a favorable tolerability profile. These findings continue to provide strong evidence for crizotinib as a standard of care for advanced ALK-positive NSCLC.

Overall population Mature population
Total no. of patients, n 901 261
Response-evaluable patients, n 803 259
Demographics:Median age, yearsMale/female, %ECOG PS 0/1, %Adenocarcinoma, % 5343/578292 5246/548394
Duration of treatment (weeks), median (range) 20 (<1 − 94) 48 (1 − 94)
ORR, % (95% exact CI) 46 (42–50) 60 (54–66)
Duration of response (weeks), mediana (95% CI) 47 (36–54) 46 (35–54)
Disease control rate, % (95% exact CI):At 6 weeksAt 12 weeks 80 (77–83)61 (58–64) 86 (82–90)75 (70–80)
PFS (months), mediana (95% CI) 8.1 (6.9–9.5) 8.1 (6.8–9.7)

ECOG PS, Eastern Cooperative Oncology Group performance status; ORR, objective response rate; PFS, progression-free survival.

aKaplan–Meier estimate

Disclosure

D. Kim: Compensated advisory relationship: Pfizer. Honoraria: Pfizer.

S. Lanzalone: Employment: Pfizer. Stock ownership: Pfizer.

A. Polli: Employment: Pfizer. Stock ownership: Pfizer.

A. Shaw: Compensated advisory relationship: Pfizer, Ariad, Chugai, Novartis, Daiichi-Sankyo. Research funding: AstraZeneca, Novartis.

All other authors have declared no conflicts of interest.